1. McDonald, Kirsten BA


Journal thoughts from a student nurse.


Article Content

The sun is just starting to rise as I pull into the hospital parking lot, turn off the engine, and take a deep breath. I'm halfway through my clinical rotation and it's another day of clinicals, another day of learning, another day of feeling stretched beyond my limits. I say a quick prayer, grab my coffee as I step out of the car, and mentally review my patients, their histories, laboratory values, and diagnoses.


My fellow student nurses and I meet in the cafeteria each morning to discuss our patients with our instructor. We are all dressed in the same royal blue scrubs. The clock strikes 6 AM. Books are gathered, hair is pulled back, and badges are donned as we walk into the elevator, bound for 3-South.


An anonymous finger presses "3," and all too soon the elevator comes to an abrupt stop. The large metal doors open and my eyes can't help but follow the stained brown and blue paisley carpet harassing the floor. Most noticeable, though, is the smell-a smell that ranges from disinfectant and diarrhea, to day-old food, to Betadine fighting a losing battle with body odor. It's a pervasive smell that reminds you where you are at all times.


We walk down the hallway, talking in hushed tones, to meet our nurse preceptor for the day. If we're lucky, we'll get a nurse who can balance her or his own duties with watching over our work and teaching us something in between. If we're not so lucky, we may get five words and a grunt.


You never know what you will find when you enter a patient's room. Sometimes it's a bossy patient who tells you in minute detail where to put the tissue box, how to put on her or his shoes, where to administer an injection, when to bring breakfast, and how much is too much ice in the water container.


But on other days, there are patients like the one I watched walk down the dying road. Mr. Carson was elderly and blind, had dementia, and was in acute renal failure. (His name and details of his case have been changed.) He was mostly unresponsive, but the longer I cared for him, the more he recognized my voice and would do the exact opposite of whatever I asked him to do. Mr. Carson got little attention from the other nurses and the physicians. He had nothing to tempt their time. But he did have something to give; we all do. I often sat with him between caring for my other patients. Mostly I would just hold his hand as I charted clinical notes or described the clouds in the sky or the tree outside his window. Over time, he slipped further into the coma.


One morning, as instrumental music sounded from his television, I started to sing an old spiritual to him. It was one of those things they teach you about in nursing school-a way to offer another dimension of healing. So in the privacy of his room, holding his hand and with tears in my eyes, I sang verse after verse. The next thing I knew, my comatose patient was responsive and yelling, "That's enough!!"


And those were the last two words I would ever hear him say. Although at the time I felt inadequate to achieve all that is expected of a nurse (or a nursing student), knowing that I could touch a patient with a simple song, even if he was asking me to stop singing, spurred me on to continue caring and learning.